486
Views
14
CrossRef citations to date
0
Altmetric
Review

Towards Patient-centered Diagnosis of Pediatric Obstructive Sleep Apnea—A Review of Biomedical Engineering Strategies

& ORCID Icon
Pages 617-629 | Received 13 Feb 2019, Accepted 29 May 2019, Published online: 08 Jun 2019

References

  • Landau YE, Bar-Yishay O, Greenberg-Dotan S, et al. Impaired behavioral and neurocognitive function in preschool children with obstructive sleep apnea. Pediatr Pulmonol. 2012;47:180–188.
  • Nieminen P, Tolonen U, Löppönen H. Snoring and obstructive sleep apnea in children: a 6 month follow-up study. Arch Otolaryngol Head Neck Surg. 2000;126:481–486.
  • Cha J, Zea-Hernandez JA, Sin S, et al. The effects of obstructive sleep apnea syndrome on the dentate gyrus and learning and memory in children. J Neurosci. 2017;37:4280–4288.
  • Marcus CL, Brooks LJ, Ward SD, et al. Diagnosis and management of childhood obstructive sleep apnea syndrome. Pediatrics 2012;130:e714–e755.
  • Mitchell RB, Kelly J. Outcome of adenotonsillectomy for obstructive sleep apnea in obese and normal-weight children. Otolaryngol Head Neck Surg. 2007;137:43–48.
  • Cullen KA, Hall MJ, Golosinskiy A. Ambulatory surgery in the United States, 2006. Natl Health Stat Rep. 2009;11:1–25.
  • Schechter MS. Technical report: diagnosis and management of childhood obstructive sleep apnea syndrome. Pediatrics. 2002;109:e69.
  • Roland PS, Rosenfeld RM, Brooks LJ, et al. Clinical practice guideline: polysomnography for sleep-disordered breathing prior to tonsillectomy in children. Otolaryngol Head Neck Surg. 2011;145:S1–15.
  • Aurora RN, Zak RS, Karippot A, et al. Practice parameters for the respiratory indications for polysomnography in children. Sleep. 2011;34:379–388.
  • Budhiraja R, Goodwin JL, Parthasarathy S, et al. Comparison of nasal pressure transducer and thermistor for detection of respiratory events during polysomnography in children. Sleep. 2005;28:1117–1121.
  • Isaiah A, Pereira KD. Outcomes after adenotonsillectomy using a fixed anesthesia protocol in children with obstructive sleep apnea. Int J Pediatr Otorhinolaryngol. 2015;79:638–643.
  • Isaiah A, Hamdan H, Johnson RF, et al. Very severe obstructive sleep apnea in children: outcomes of adenotonsillectomy and risk factors for persistence. Otolaryngol Head Neck Surg. 2017;157:128–134.
  • Mitchell RB, Pereira KD, Friedman NR. Sleep-disordered breathing in children: survey of current practice. Laryngoscope. 2006;116:956–958.
  • Horwood L, Brouillette RT, McGregor CD, et al. Testing for pediatric obstructive sleep apnea when health care resources are rationed. JAMA Otolaryngol– Head Neck Surg. 2014;140:616–623.
  • Kapur VK, Auckley DH, Chowdhuri S, et al. Clinical practice guideline for diagnostic testing for adult obstructive sleep apnea: an american academy of sleep medicine clinical practice guideline. J Clin Sleep Med JCSM Off Publ Am Acad Sleep Med. 2017;13:479–504.
  • Kirk V, Baughn J, D’Andrea L, et al. American academy of sleep medicine position paper for the use of a home sleep apnea test for the diagnosis of OSA in children. J Clin Sleep Med JCSM Off Publ Am Acad Sleep Med. 2017;13:1199–1203.
  • Collop NA, Tracy SL, Kapur V, et al. Obstructive sleep apnea devices for out-of-center (OOC) testing: technology evaluation. J Clin Sleep Med JCSM Off Publ Am Acad Sleep Med. 2011;7:531–548.
  • Ruehland WR, O’Donoghue FJ, Pierce RJ, et al. The 2007 AASM recommendations for EEG electrode placement in polysomnography: impact on sleep and cortical arousal scoring. Sleep. 2011;34:73–81.
  • Morielli A, Ladan S, Ducharme FM, et al. Can sleep and wakefulness be distinguished in children by cardiorespiratory and videotape recordings? Chest. 1996;109:680–687.
  • Bandla HP, Gozal D. Dynamic changes in EEG spectra during obstructive apnea in children. Pediatr Pulmonol. 2000;29:359–365.
  • Yang JSC, Nicholas CL, Nixon GM, et al. EEG spectral analysis of apnoeic events confirms visual scoring in childhood sleep disordered breathing. Sleep Breath Schlaf Atm. 2012;16:491–497.
  • Chervin RD, Fetterolf JL, Ruzicka DL, et al. Sleep stage dynamics differ between children with and without obstructive sleep apnea. Sleep. 2009;32:1325–1332.
  • Lopez-Gordo MA, Sanchez-Morillo D, Valle FP. Dry EEG electrodes. Sensors. 2014;14:12847–12870.
  • Shokoueinejad M, Fernandez C, Carroll E, et al. Sleep apnea: a review of diagnostic sensors, algorithms, and therapies. Physiol Meas. 2017;38:R204–R252.
  • Jeffries B, Brouillette RT, Hunt CE. Electromyographic study of some accessory muscles of respiration in children with obstructive sleep apnea. Am Rev Respir Dis. 1984;129:696–702.
  • de Felicio CM, Da Silva Dias FV, Folha GA, et al. Orofacial motor functions in pediatric obstructive sleep apnea and implications for myofunctional therapy. Int J Pediatr Otorhinolaryngol. 2016;90:5–11.
  • Berthomier C, Drouot X, Herman-Stoïca M, et al. Automatic analysis of single-channel sleep EEG: validation in healthy individuals. Sleep. 2007;30:1587–1595.
  • Levendowski DJ, Popovic D, Berka C, et al. Retrospective cross-validation of automated sleep staging using electroocular recording in patients with and without sleep disordered breathing. Int Arch Med. 2012;5:21.
  • Virkkala J, Toppila J, Maasilta P, et al. Electro-oculography-based detection of sleep-wake in sleep apnea patients. Sleep Breath Schlaf Atm. 2015;19:785–789.
  • Minguillon J, Lopez-Gordo MA, Pelayo F. Trends in EEG-BCI for daily-life: requirements for artifact removal. Biomed Signal Process Control. 2017;31:407–418.
  • Hayano J, Watanabe E, Saito Y, et al. Screening for obstructive sleep apnea by cyclic variation of heart rate. Circ Arrhythm Electrophysiol. 2011;4:64–72.
  • Heneghan C, Chua C-P, Garvey JF, et al. A portable automated assessment tool for sleep apnea using a combined holter-oximeter. Sleep. 2008;31:1432–1439.
  • Shouldice RB, O’Brien LM, O’Brien C, et al. Detection of obstructive sleep apnea in pediatric subjects using surface lead electrocardiogram features. Sleep. 2004;27:784–792.
  • Narkiewicz K, Montano N, Cogliati C, et al. Altered cardiovascular variability in obstructive sleep apnea. Circulation. 1998;98:1071–1077.
  • Nisbet LC, Yiallourou SR, Nixon GM, et al. Nocturnal autonomic function in preschool children with sleep-disordered breathing. Sleep Med. 2013;14:1310–1316.
  • Aljadeff G, Gozal D, Schechtman VL, et al. Heart rate variability in children with obstructive sleep apnea. Sleep. 1997;20:151–157.
  • Baharav A, Kotagal S, Rubin BK, et al. Autonomic cardiovascular control in children with obstructive sleep apnea. Clin Auton Res Off J Clin Auton Res Soc. 1999;9:345–351.
  • Varon C, Caicedo A, Testelmans D, et al. A novel algorithm for the automatic detection of sleep apnea from single-lead ECG. IEEE Trans Biomed Eng. 2015;62:2269–2278.
  • Khandoker AH, Palaniswami M, Karmakar CK. Support vector machines for automated recognition of obstructive sleep apnea syndrome from ECG recordings. IEEE Trans Inf Technol Biomed. 2009;13:37–48.
  • Al-Angari HM, Sahakian AV. Automated recognition of obstructive sleep apnea syndrome using support vector machine classifier. IEEE Trans Inf Technol Biomed. 2012;16:463–468.
  • O’Brien LM, Gozal D. Autonomic dysfunction in children with sleep-disordered breathing. Sleep. 2005;28:747–752.
  • Lázaro J, Gil E, Vergara JM, et al. Pulse rate variability analysis for discrimination of sleep-apnea-related decreases in the amplitude fluctuations of pulse photoplethysmographic signal in children. IEEE J Biomed Health Inform. 2014;18:240–246.
  • Tauman R, O’Brien LM, Mast BT, et al. Peripheral arterial tonometry events and electroencephalographic arousals in children. Sleep. 2004;27:502–506.
  • Choi JH, Kim EJ, Kim YS, et al. Validation study of portable device for the diagnosis of obstructive sleep apnea according to the new AASM scoring criteria: watch-PAT 100. Acta Otolaryngol. (Stockh.). 2010;130:838–843.
  • Yalamanchali S, Farajian V, Hamilton C, et al. Diagnosis of obstructive sleep apnea by peripheral arterial tonometry: meta-analysis. JAMA Otolaryngol– Head Neck Surg. 2013;139:1343–1350.
  • Pittman SD, Ayas NT, MacDonald MM, et al. Using a wrist-worn device based on peripheral arterial tonometry to diagnose obstructive sleep apnea: in-laboratory and ambulatory validation. Sleep. 2004;27:923–933.
  • Serra A, Cocuzza S, Maiolino L, et al. The watch-pat in pediatrics sleep disordered breathing: pilot study on children with negative nocturnal pulse oximetry. Int J Pediatr Otorhinolaryngol. 2017;97:245–250.
  • Tanphaichitr A, Thianboonsong A, Banhiran W, et al. Watch peripheral arterial tonometry in the diagnosis of pediatric obstructive sleep apnea. Otolaryngol Head Neck Surg Off J Am Acad Otolaryngol-Head Neck Surg. 2018;159:166–172.
  • Su M, Yu C, Zhang Y, et al. Clinical value of portable sleep testing in children with obstructive sleep apnea syndrome. Zhonghua Er Ke Za Zhi Chin J Pediatr. 2015;53:845–849.
  • Onder NS, Akpinar ME, Yigit O, et al. Watch peripheral arterial tonometry in the diagnosis of obstructive sleep apnea: influence of aging. Laryngoscope. 2012;122:1409–1414.
  • Pepin J-L, Delavie N, Pin I, et al. Pulse transit time improves detection of sleep respiratory events and microarousals in children. Chest. 2005;127:722–730.
  • Katz ES, Lutz J, Black C, et al. Pulse transit time as a measure of arousal and respiratory effort in children with sleep-disordered breathing. Pediatr Res. 2003;53:580–588.
  • Gil E, Bailón R, Vergara JM, et al. PTT variability for discrimination of sleep apnea related decreases in the amplitude fluctuations of PPG signal in children. IEEE Trans Biomed Eng. 2010;57:1079–1088.
  • Bradley J, Galland BC, Bakker JP, et al. Pulse transit time and assessment of childhood sleep disordered breathing. Arch Otolaryngol Head Neck Surg. 2012;138:398–403.
  • Brietzke SE, Katz ES, Roberson DW. Pulse transit time as a screening test for pediatric sleep-related breathing disorders. Arch Otolaryngol Head Neck Surg. 2007;133:980–984.
  • Gozal D. Sleep-disordered breathing and school performance in children. Pediatrics. 1998;102:616–620.
  • Wukitsch MW, Petterson MT, Tobler DR, et al. Pulse oximetry: analysis of theory, technology, and practice. J Clin Monit. 1988;4:290–301.
  • Zafar S, Ayappa I, Norman RG, et al. Choice of oximeter affects apnea-hypopnea index. Chest. 2005;127:80–88.
  • Kaditis A, Kheirandish-Gozal L, Gozal D. Pediatric OSAS: oximetry can provide answers when polysomnography is not available. Sleep Med Rev. 2016;27:96–105.
  • Brouillette RT, Morielli A, Leimanis A, et al. Nocturnal pulse oximetry as an abbreviated testing modality for pediatric obstructive sleep apnea. Pediatrics. 2000;105:405–412.
  • Nixon GM, Kermack AS, Davis GM, et al. Planning adenotonsillectomy in children with obstructive sleep apnea: the role of overnight oximetry. Pediatrics. 2004;113:e19–25.
  • Kirk VG, Bohn SG, Flemons WW, et al. Comparison of home oximetry monitoring with laboratory polysomnography in children. Chest. 2003;124:1702–1708.
  • Owen-Reece H, Smith M, Elwell CE, et al. Near infrared spectroscopy. Br J Anaesth. 1999;82:418–426.
  • Ullman N, Anas NG, Izaguirre E, et al. Usefulness of cerebral NIRS in detecting the effects of pediatric sleep apnea. Pediatr Pulmonol. 2014;49:1036–1042.
  • Meltzer LJ, Montgomery-Downs HE, Insana SP, et al. Use of actigraphy for assessment in pediatric sleep research. Sleep Med Rev. 2012;16:463–475.
  • Meltzer LJ, Wong P, Biggs SN, et al. Validation of actigraphy in middle childhood. Sleep. 2016;39:1219–1224.
  • Meltzer LJ, Walsh CM, Traylor J, et al. Direct comparison of two new actigraphs and polysomnography in children and adolescents. Sleep. 2012;35:159–166.
  • Meltzer LJ, Hiruma LS, Avis K, et al. Comparison of a commercial accelerometer with polysomnography and actigraphy in children and adolescents. Sleep. 2015;38:1323–1330.
  • Toon E, Davey MJ, Hollis SL, et al. Comparison of commercial wrist-based and smartphone accelerometers, actigraphy, and PSG in a clinical cohort of children and adolescents. J Clin Sleep Med JCSM Off Publ Am Acad Sleep Med. 2016;12:343–350.
  • Sadeh A, Hauri PJ, Kripke DF, et al. The role of actigraphy in the evaluation of sleep disorders. Sleep. 1995;18:288–302.
  • Kushida CA, Chang A, Gadkary C, et al. Comparison of actigraphic, polysomnographic, and subjective assessment of sleep parameters in sleep-disordered patients. Sleep Med. 2001;2:389–396.
  • Hedner J, Pillar G, Pittman SD, et al. A novel adaptive wrist actigraphy algorithm for sleep-wake assessment in sleep apnea patients. Sleep. 2004;27:1560–1566.
  • Morgenthaler T, Alessi C, Friedman L, et al. Practice parameters for the use of actigraphy in the assessment of sleep and sleep disorders: an update for 2007. Sleep. 2007;30:519–529.
  • Waltisberg D, Amft O, Brunner DP, et al. Detecting disordered breathing and limb movement using in-bed force sensors. IEEE J Biomed Health Inform. 2017;21:930–938.
  • Park S, Shin H. Feasibility study for unconstrained respiration monitoring based on multi-way approach using an acceleration and force sensing module. IEEE Sens J. 2017;17:3482–3489.
  • Fernandes Do Prado LB, Li X, Thompson R, et al. Body position and obstructive sleep apnea in children. Sleep. 2002;25:66–71.
  • Bronstein JZ, Brooks LJ. A potential alternative to respiratory inductance plethysmography for children? J Clin Sleep Med JCSM Off Publ Am Acad Sleep Med. 2016;13:159–160.
  • Skiba V, Goldstein C, Schotland H. Night-to-night variability in sleep disordered breathing and the utility of esophageal pressure monitoring in suspected obstructive sleep apnea. J Clin Sleep Med JCSM Off Publ Am Acad Sleep Med. 2014;11:597–602.
  • Cohn MA, Rao AS, Broudy M, et al. The respiratory inductive plethysmograph: a new non-invasive monitor of respiration. Bull Eur Physiopathol Respir. 1982;18:643–658.
  • East KA, East TD, John Mathews V, et al. Computerized artifact detection for ventilatory inductance plethysmographic apnea monitors. J Clin Monit. 1989;5:170–176.
  • Cohen KP, Panescu D, Booske JH, et al. Design of an inductive plethysmograph for ventilation measurement. Physiol Meas. 1994;15:217–229.
  • Mason DG, Iyer K, Terrill PI, et al. Pediatric obstructive sleep apnea assessment using pulse oximetry and dual RIP bands. Conf Proc Annu Int Conf IEEE Eng Med Biol Soc IEEE Eng Med Biol Soc Annu Conf. 2010;2010:6154–6157.
  • Infantile apnea and home monitoring. Natl Inst Health Consens Dev Conf Consens Statement. 1986;6:1–10.
  • Sahakian AV, Tompkins WJ, Webster JG. Electrode motion artifacts in electrical impedance pneumography. IEEE Trans Biomed Eng. 1985;BME-32:448–451.
  • Miyasaka K, Kondo Y, Suzuki T, et al. Toward better home respiratory monitoring: a comparison of impedance and inductance pneumography. Acta Paediatr Jpn Overseas Ed. 1994;36:307–310.
  • Jacob SV, Morielli A, Mograss MA, et al. Home testing for pediatric obstructive sleep apnea syndrome secondary to adenotonsillar hypertrophy. Pediatr Pulmonol. 1995;20:241–252.
  • Griffiths AG, Patwari PP, Loghmanee DA, et al. Validation of polyvinylidene fluoride impedance sensor for respiratory event classification during polysomnography in children. J Clin Sleep Med JCSM Off Publ Am Acad Sleep Med. 2017;13:259–265.
  • Hwang SH, Lee HJ, Yoon HN, et al. Unconstrained sleep apnea monitoring using polyvinylidene fluoride film-based sensor. IEEE Trans Biomed Eng. 2014;61:2125–2134.
  • Farre R, Montserrat JM, Navajas D. Noninvasive monitoring of respiratory mechanics during sleep. Eur Respir J. 2004;24:1052–1060.
  • Norman RG, Ahmed MM, Walsleben JA, et al. Detection of respiratory events during NPSG: nasal cannula/pressure sensor versus thermistor. Sleep. 1997;20:1175–1184.
  • Rofail LM, Wong KKH, Unger G, et al. The role of single-channel nasal airflow pressure transducer in the diagnosis of OSA in the sleep laboratory. J Clin Sleep Med JCSM Off Publ Am Acad Sleep Med. 2010;6:349–356.
  • Rofail LM, Wong KKH, Unger G, et al. Comparison between a single-channel nasal airflow device and oximetry for the diagnosis of obstructive sleep apnea. Sleep. 2010;33:1106–1114.
  • Trang H, Leske V, Gaultier C. Use of nasal cannula for detecting sleep apneas and hypopneas in infants and children. Am J Respir Crit Care Med. 2002;166:464–468.
  • Serebrisky D, Cordero R, Mandeli J, et al. Assessment of inspiratory flow limitation in children with sleep-disordered breathing by a nasal cannula pressure transducer system. Pediatr Pulmonol. 2002;33:380–387.
  • Lesser DJ, Haddad GG, Bush RA, et al. The utility of a portable recording device for screening of obstructive sleep apnea in obese adolescents. J Clin Sleep Med JCSM Off Publ Am Acad Sleep Med. 2012;8:271–277.
  • Pevernagie D, Aarts RM, De Meyer M. The acoustics of snoring. Sleep Med Rev. 2010;14:131–144.
  • Leiberman A, Cohen A, Tal A. Digital signal processing of stridor and snoring in children. Int J Pediatr Otorhinolaryngol. 1986;12:173–185.
  • Rembold CM, Suratt PM. Children with obstructive sleep-disordered breathing generate high-frequency inspiratory sounds during sleep. Sleep. 2004;27:1154–1161.
  • Carin L, John M, Meyer K. Evaluation of home audiotapes as an abbreviated test for obstructive sleep apnea syndrome (OSAS) in children. Pediatr Pulmonol. 1999;27:267–272.
  • Bastanlar Y, Ozuysal M. Introduction to machine learning. Methods Mol Biol Clifton NJ. 2014;1107:105–128.
  • Corrales M, Cusco P, Usmanova DR, et al. Machine learning: how much does it tell about protein folding rates? PloS One. 2015;10:e0143166.
  • Kang J, Schwartz R, Flickinger J, et al. Machine learning approaches for predicting radiation therapy outcomes: a clinician’s perspective. Int J Radiat Oncol Biol Phys. 2015;93:1127–1135.
  • Hornero R, Kheirandish-Gozal L, Gutiérrez-Tobal GC, et al. Nocturnal oximetry-based evaluation of habitually snoring children. Am J Respir Crit Care Med. 2017;196:1591–1598.
  • Oliveira VXN, Teng AY. The clinical usefulness of sleep studies in children. Paediatr Respir Rev. 2016;17:53–56.
  • Berry RB, Budhiraja R, Gottlieb DJ, et al. Rules for scoring respiratory events in sleep: update of the 2007 AASM manual for the scoring of sleep and associated events. deliberations of the sleep apnea definitions task force of the American academy of sleep medicine. J Clin Sleep Med. JCSM Off. Publ. Am. Acad. Sleep Med. 2012;8:597–619.
  • Smith RP, Argod J, Pepin JL, et al. Pulse transit time: an appraisal of potential clinical applications. Thorax. 1999;54:452–457.
  • Domingos P. A few useful things to know about machine learning. Commun ACM. 2012;55:78–87.
  • Kheirandish-Gozal L, Gozal D. Pediatric OSA syndrome morbidity biomarkers: the hunt is finally on! Chest. 2017;151:500–506.
  • Mitchell RB, Garetz S, Moore RH, et al. The use of clinical parameters to predict obstructive sleep apnea syndrome severity in children: the childhood adenotonsillectomy (CHAT) study randomized clinical trial. JAMA Otolaryngol– Head Neck Surg. 2015;141:130–136.
  • Rookham S, Hittle M, Lovell D, Perrin D. Can we use the apple watch to measure sleep reliably? J Sleep Res. 2018;27:e153_12766.

Reprints and Corporate Permissions

Please note: Selecting permissions does not provide access to the full text of the article, please see our help page How do I view content?

To request a reprint or corporate permissions for this article, please click on the relevant link below:

Academic Permissions

Please note: Selecting permissions does not provide access to the full text of the article, please see our help page How do I view content?

Obtain permissions instantly via Rightslink by clicking on the button below:

If you are unable to obtain permissions via Rightslink, please complete and submit this Permissions form. For more information, please visit our Permissions help page.